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PERMITTER NAME/ADDRESS (Include Faclllry Namo/LocadonVDVOMO <br />NAME N W ELK Cm A-r-. _ ?,om PArVf/ .Wr.G <br />ADDRESS I z-Z 1N Ff?2Si'?' S'7: <br />7-ri /ti)*D ' CD' <br />FACIUTV ,NEW AFL )t MI11/0' y r <br />LOCATION jf!(bl? CO <br />M.0 TALE r <br />NATIONAL POLWTAtW' DISCHARGE RUMINATION svmm (NPDES) Form Approved. <br />DISCHARGE MONITORING REPORT (DMA) OMB No. 2040 coca <br />MINOR <br />Fao'•OOb D (SUBR DK ) <br />'PERMIT bNUMar " DIS ARE 1 MBER F - F I I?tAL LAMAS <br />?naQ, 711) vcc?`?p?/`e <br />MONITORING PERIOD FROM YEAR MO DAY TO . YEAR MO DAY NO D I SCHAR @'E I X.1 <br />?M <br />NoTP: Read Instructions before completing this form. <br />RYNrq C. <br />N0 <br />FREQ <br />U <br />NCY <br />SAMPLE <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION <br />. <br />g <br />F <br />TYPE <br /> AN0816 <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNIT'S <br />OIL AND GREASE SAMPLE <br />EM <br />NT gab#??# t 94> <br />VISUAL E <br />MEASUR ~K t <br />ISll <br />1 RF]faIT': <br />: 1F? r111'r tµr?31 at #i?3A?i31# # L <br />> t <br />934066 1 0 ,; <br />eei,?titletxNeett?wr :.... `... . ,:' ti. r.to .?r. • lMf?.st..`: tali"l= f 1 ii yr <br /> SAMPLE <br /> MEASUREMENT <br /> ' , f <br /> ; f `PSIIIAI?T • y <br /> pLCtMliR . lNT' ? , <br /> SAMPLE <br /> NT <br />SUREM <br /> E <br />MEA <br /> <br />{TERN47? ?ti <br /> ?I?±ditllq?M.ENT <br /> SAMPLE <br /> SUREMENT <br /> MEA 7777 <br /> pEiitllllT 7 <br /> . <br /> <br />gFrClUI EIYIE `? <br /> <br />.: <br />- 1 <br /> SAMPLE L ;0 <br /> MEASUREMENT <br /> #MtT <br /> <br /> SAMPLE <br /> MEASUREMENT <br /> <br /> lanraulp?ialulENT <br />- SAMPLE <br />MEASUREMENT <br />r, <br />:. <br />r. <br />'RE?1?,1iR? ANT' <br />TELEPHONE DATE <br />NAMEITITLE PRINCIPAL EXECUTIVE OFFICER I eerdty under penalty of tow that We document end all attachments were <br />prepared under m direction or ouporvkian is eoomdonce with a system daaigaad <br />A- V' RE to assure that qualified penonnal properly gather and evaluate the Iofamratlon Q sy b' ?9 75 <br />who mean o die syatom, , b Q ?? 27 <br />,y. submitted. Heaad oa inquiry of the person or PM= <br />A T oe those parsons dim y respooelble f" Bath' The tafbtmatior% o information ("J <br />?!`!'.S I o(2 d1 euonlaed 1e, to the bast of mytnowtedge cad be we, aoaurote, and complete. SIGNATURE OF PRINCIPAL EXEC NE - - - - - - - - <br />I am owate that theca are atppelnaaat paauhies for submUtins fake htfomtedon, OFFICER OR AUTHORIZED AGENT NUMBER YEAR MO DAY <br />TYPED ON PRINTED Including the possibility of be and Impdaonment for kaowios violations. <br />rOMMENTS AND EXPLANATION OF ANY VIOLATIONS eference all alts Menlo here <br />TSg, IRON & MANGANESE LIMITS WILL BE WAIVED At SETTLEABLE 80LIDS LIMIT APPLIED FOR <=1OYRj 24HH ri" r-U-Lr <br />1EVENTI TSS, IRON & SETTLEABLE SOLIDS LIMITS, WAIVED FOR ; 10YR, d4Hh PRECIP EVENT SUBJECT TO BURDEN OF PROOF <br />0 <br />PAGE -5F